Cerebral perfusion protection in newborns after surgical correction of aortic coarctation with aortic arch hypoplasia

Aim: To compare the rate of neurologic complications in infants with aortic coarctation and aortic arch hypoplasia undergoing aortic arch repair under deep hypothermic circulatory arrest or full-flow perfusion with double arterial cannulation.

Material and Methods: This pilot single-center simple blinded prospective study assessed the early postoperative outcomes in infants with aortic arch obstruction. Patients underwent on-pump repair under deep hypothermic circulatory arrest (I group, 20 patients) or full-flow perfusion with double arterial cannulation (II group, 20 patients).

Results: In-hospital mortality was 5% (1 patient) in each group (p>0.05). Neurologic complications occurred in 14 (70%) patients of the 1st group and 6 patients (30%) of the 2nd group (p=0.025). The only significant risk factor was head tissue saturation according to near-infrared spectroscopy. Each percent decreased the risk of neurologic event by 6%.

Conclusion: Aortic arch repair under full-flow perfusion reduces the rate of neurologic events in infants compared to deep hypo- thermic circulatory arrest. Head tissue saturation was the risk factor of neurologic complications. Each percent decreased the risk of neurologic event by 6%.